I am afraid of getting a colonoscopy, do I really need one?

By: Murthy Badiga, MD, FACP, FACG, AGAF
DHR Health Gastroenterology Institute

Having performed well over 50,000 colonoscopies in my career, I have heard pretty much every excuse and fear about the colonoscopy procedure. So I have decided to put my scope down, and talk plainly about the fears and anxieties you may have about your first colonoscopy.

Why colonoscopy?

Colonoscopy remains the gold standard when it comes to colorectal cancer prevention. It detects pre-cancerous polyps which are removed thereby preventing colon cancer. Of course, we also detect colon cancers early when a cure is highly likely. It is well established that colonoscopies have reduced the incidence of and mortality from colorectal cancer every year since the screening test came into being. The age to start colonoscopy screening was recently reduced from 50 to 45 because of the increasing number of cases of colon cancer between ages 45 and 50. If the test is negative you can repeat it in 10 years.

Is it painful?

The colonoscopy procedure on average takes about 15 minutes and IV sedation makes sure you do not feel any pain or discomfort during the procedure. We at DHR Health use carbon dioxide (CO2) as opposed to air to insufflate or distend the large intestine to examine the inner lining. CO2 dissipates 400 times faster than air thereby preventing discomfort after the procedure.

The prep is awful!

I admit the prep part is not fun. You need to be on a clear liquid diet for the entire day prior to colonoscopy and take a laxative prep to clean the colon. The preps are getting better, but it is still no picnic. On the positive side, it is a clean reset for your bowels and you might lose a pound or two in body weight.

I am very healthy, why would I need a colonoscopy?

Colonoscopy screening unfortunately is skipped by many Americans to their detriment. Remember a screening test by definition is done on healthy people when there are no symptoms to detect silent abnormalities like polyps and early cancer. Of the 20 counties in the USA with the lowest colorectal cancer screening rates, 6 of them are in South Texas and

include Starr, Willacy, Brooks, and Zapata. In Texas, only 42% of the eligible Hispanic population is screened compared to Non-Hispanic Whites at 67% and Non-Hispanic Blacks at 69%.

I know there are easier alternatives!

Yes, a CT colonography or a Barium Enema is a little easier, but still needs preparation and relies on X-rays to find abnormal growths, and requires repeating every five years. If there is an abnormality you have to undergo a colonoscopy still. The same is true for at-home fecal immunochemical tests (FITs) or fecal DNA tests (such as Cologuard), which by the way do not detect precancerous lesions. A colonoscopy not only can screen for or diagnose cancer, but it can also be interventional by removing precancerous and even some cancerous polyps.

I am embarrassed

It is understandable, but please don’t let embarrassment prevent you from having this very important and life-saving screening test. You are not alone. All of our patients are there for GI care, and our staff handles your screening with utmost privacy and care. We are all in this together.

I am terrified about what you might find

The fear of “what if you find something” is not very uncommon. But, if something is there, it needs to be found! By removing polyps before they turn into cancer, you are preventing future problems. If colon cancer is found at the time of a colonoscopy then biopsies can be taken and a treatment plan laid out. The good news is that colon cancer is very treatable and often curable when caught early. The take-home message is that it is much better to find polyps that can be removed or early cancer which can often be cured, rather than advanced cancer.

DHR Health Gastroenterology Institute can help guide you through the process of getting your screening scheduled. If you or a loved one would like more information or to speak to one of our experts, please call the DHR Health Gastroenterology Institute at (956) 362-3636.